Intraoperative presentation of an undiagnosed tracheoesophageal fistula in an adult without history of abdominal or thoracic surgery.

Tracheoesophageal fistula is uncommon in adults but can cause devastating aspiration events. Herein, we report a unique case of a tracheoesophageal fistula in an adult that presented intraoperatively. The patient did not have any prior history of abdominal or thoracic surgery and was not intubated for a prolonged period of time.

Minimally-invasive pain management techniques in palliative care.

Pain is a common source of suffering for seriously ill patients. Typical first-line treatments consist of lifestyle modifications and medication therapy, including opioids. However, medical treatments often fail or are associated with limiting systemic toxicities, and more targeted interventional approaches are necessary.

Identification of tetracycline combinations as EphB1 tyrosine kinase inhibitors for treatment of neuropathic pain.

Previous studies have demonstrated that the synaptic EphB1 receptor tyrosine kinase is a major mediator of neuropathic pain, suggesting that targeting the activity of this receptor might be a viable therapeutic option. Therefore, we set out to determine if any FDA-approved drugs can act as inhibitors of the EphB1 intracellular catalytic domain. An in silico screen was first used to identify a number of tetracycline antibiotics which demonstrated potential docking to the ATP-binding catalytic domain of EphB1.

Quantitative Sensory Testing Discriminates Central Sensitization Inventory Scores in Participants with Chronic Musculoskeletal Pain: An Exploratory Study.

Background: The Central Sensitization Inventory (CSI) is often used in clinical settings to screen for the presence of central sensitization. However, various cutoff scores have been reported for this tool, and scores have not been consistently associated with widespread pain sensitivity as measured with quantitative sensory testing (QST). The purpose of this study was to compare QST profiles among asymptomatic controls and participants with chronic musculoskeletal pain (CMP), and to determine the association between self-report questionnaires and QST in participants with CMP.

The Efficacy of Lidocaine in Disrupting Cocaine Cue-Induced Memory Reconsolidation.

Rational: Cue-induced craving memories, linked to drug-seeking behaviors, require key molecular processes for memory reconsolidation. Lidocaine, a sodium channel blocker, inhibits NMDA receptor activation and suppresses nitric oxide and ERK production. These processes are required for memory re-consolidation; inhibiting them may reduce cue-related craving memories in cocaine dependent subjects.

Opioid prescribing practices in a pediatric burn tertiary care facility: Is it time to change?

Opioids are the mainstay therapy in burned adults. Little data in the pediatric burn population exists that elucidates opioid prescribing practices. The primary purpose of this report is to quantify opioid and non-opioid analgesic use in pediatric burn patients admitted to a tertiary referral burn center.

Complex regional pain syndrome type 1 predictors - Epidemiological perspective from a national database analysis.

Objective: Complex regional pain syndrome type 1 is a disabling pain disorder with unclear etiology. It is usually triggered by an injury to a limb with or without specific nerve injury. The objective of this study is to explore the risk factors and predictors for this disease utilizing a large national database.

Lidocaine Infusion: A Promising Therapeutic Approach for Chronic Pain.

Opioid abuse is a national epidemic in the United States, where it is estimated that a prescription drug overdose death occurs every 19 minutes. While opioids are highly effective in acute and subacute pain control, their use for treatment of chronic pain is controversial. Chronic opioids use is associated with tolerance, dependency, hyperalgesia.

Outcomes of a preoperative "bridging" strategy with glycoprotein IIb/IIIa inhibitors to prevent perioperative stent thrombosis in patients with drug-eluting stents who undergo surgery necessitating interruption of thienopyridine administration.

Aims: Surgery after drug-eluting stent (DES) implantation may be associated with increased risk for perioperative stent thrombosis (ST).

Methods And Results: We evaluated the outcomes of 67 patients who underwent non-cardiac (n=51) or cardiac (n=16) surgery after DES implantation at our institution between 2008 and 2010 and who underwent preoperative "bridging" with a glycoprotein IIb/IIIa inhibitor. Surgery occurred after a mean time of 13.

Anesthetic management for laser excision of recurrent respiratory papillomatosis in a third trimester parturient.

Recurrent respiratory papillomatosis (RRP) is characterized by the development of laryngeal papillomas, which can produce partial to complete upper airway obstruction. Patients with RRP often require intermittent surgical excision to treat symptoms such as hoarseness and stridor, and to control progression of the lesions. The anesthetic management of such patients is challenging, and it requires carefully coordinated care between an anesthesiologist and otolaryngologist.